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Phys Ther Sport 2021 Jun 9;51:1-7. Epub 2021 Jun 9.

Centre for Injury Prevention and Performance, Athletic Therapy and Training, School of Health and Human Performance, Dublin City University, Dublin 9, Ireland.

Objective: To understand the incidence and burden of injury of student-athletes in four of the most popular collegiate sports.

Design: Prospective cohort study.

Setting: Collegiate sport. Read More

Sports Med 2021 Jun 18. Epub 2021 Jun 18.

Department of Rehabilitation Sciences, Ghent University, University Hospital, Corneel Heymanslaan 10, 3B3, 9000, Ghent, Belgium.

Return to play (RTP) criteria after hamstring strain injuries (HSIs) help clinicians in deciding whether an athlete is ready to safely resume previous sport activities. Today, functional and sport-specific training tests are the gold standard in the decision-making process. These criteria lead to an average RTP time between 11 and 25 days after a grade 1 or 2 HSI. Read More

Unfallchirurg 2021 Jun 18. Epub 2021 Jun 18.

Klinik für Orthopädie und Unfallchirurgie, DIAKOVERE Friederikenstift, Humboldtstr. 5, 30169, Hannover, Deutschland.

Background: Avulsion injuries of the proximal hamstring muscles are rare but very severe injuries to the dorsal thigh musculature.

Objective: Due to improved diagnostics and experience in treatment, the decision for surgical treatment is becoming more and more frequent. Presentation of the surgical method, follow-up treatment and outcome. Read More

J Orthop Case Rep 2021 Feb;11(2):41-44

Department of General Medicine , Narayana Medical College, Nellore, Andhra Pradesh,India.

Introduction: Reconstruction of the anterior cruciate ligament (ACL) is a common procedure. Injury is the predisposing risk factor for developing heterotopic ossification(HO). We like to report a case of HO of the knee following arthroscopic ACL reconstruction. Read More

Arthrosc Tech 2021 May 18;10(5):e1307-e1313. Epub 2021 Apr 18.

Department of Orthopaedic Surgery, Virginia Commonwealth University Health System, Richmond, Virginia.

While proximal hamstring tears at the myotendinous junction are common sports-related injuries that are often successfully treated nonoperatively, complete avulsions from the origin on the ischial tuberosity are less common and better treated with surgical repair to prevent significant functional limitations and ongoing weakness. The diagnosis can be easily missed, leading patients to present several months after the initial injury. In addition, some patients decide on nonoperative management initially but later present requesting surgical intervention. Read More

J Athl Train 2021 Jun 15. Epub 2021 Jun 15.

University of Wisconsin-Madison, Madison, WI, USA.

Hamstring strain injuries are common among athletes and often require rehabilitation to prepare for timely return to sport performance, while also minimizing re-injury risk. Return to sport is typically achieved within weeks of the injury, but subsequent athlete performance may be impaired and re-injury rates are high. Improving these outcomes requires rehabilitation practitioners (e. Read More

Int J Sports Phys Ther 2021 Jun 1;16(3):704-714. Epub 2021 Jun 1.

Human Movement Analysis Laboratory, Dept. of Orthopaedic Surgery, Copenhagen University Hospital Amager-Hvidovre, Hvidovre, Denmark.

Background: Reduced activation of the hamstring muscles and specifically the medial semitendinosus muscle (ST) has been shown to be a risk factor for non-contact anterior cruciate ligament (ACL) injury. Specific hamstring strength exercises may show high ST activity, however the effect of unilateral vs. bilateral exercise execution on ST activation remains unknown. Read More

Eur J Sport Sci 2021 Jun 10:1-17. Epub 2021 Jun 10.

Institute for Diagnostic and Interventional Radiology, Goethe University Frankfurt, Frankfurt am Main, Germany.

Muscle injuries of the hamstrings are among the most frequent in football and a main cause for significant time away from training and competition. The purpose of this study was to prospectively evaluate the loss of muscle volume in recreational football players three and six weeks after initial trauma. We hypothesized that significant muscle volume loss occurs within 6 weeks after the initial injury event. Read More

Eur J Orthop Surg Traumatol 2021 Jun 10. Epub 2021 Jun 10.

Department of Orthopaedics, Penn State Health Milton S. Hershey Medical Center, 500 University Dr., 414 Hallmark South, Hershey, PA, 17033, USA.

Background: Multiple graft options exist for anterior cruciate ligament (ACL) reconstruction in an adolescent athlete. Patellar tendon harvest can lead to anterior knee pain, while hamstring tendon harvest can affect knee flexion strength and alter mechanics. Allograft is less desirable in pediatric patients due to the higher failure rate and slight risk of disease transmission. Read More

Am J Sports Med 2021 Jun 8:3635465211015172. Epub 2021 Jun 8.

Sports Orthopedic Research Center-Copenhagen (SORC-C), Department of Orthopedic Surgery, Copenhagen University Hospital Amager-Hvidovre, Denmark.

Background: It has been indicated that anterior cruciate ligament reconstruction (ACLR) with a quadriceps tendon (QT) graft has a higher risk of revision compared with ACLR performed with a hamstring tendon (HT) graft.

Purpose/hypothesis: To investigate whether ACLR with QT graft had a higher risk of graft failure, revision ACLR, or reoperation compared with HT graft in a high-volume center. We hypothesized that there would be no between-group differences. Read More

Int J Prev Med 2021 19;12. Epub 2021 Jan 19.

Department of Sport Management, Faculty of Management, Farabi Campus, University of Tehran, Iran.

Background: Multiple sclerosis (MS) is the third most common cause of adult neurologic disabilities. The aim of this study was to determine the effect of 8 weeks of neuromuscular exercises on strength, proprioceptive receptors, and balance of women with MS.

Methods: In this randomized controlled trial study, 20 female volunteers with relapsing-remitting MS were randomly assigned into the experimental group ( = 10) and control group ( = 10). Read More

J Phys Ther Sci 2021 May 15;33(5):439-443. Epub 2021 May 15.

Department of Physical Therapy, Crean College of Health & Behavioral Sciences, Rinker Health Science Campus in Irvine, Chapman University: 9401 Jeronimo Rd, Irvine, CA 92618, USA.

[Purpose] Determine if female adolescent soccer players with a history of concussion, impaired K-D scores, and pre-season subjective complaints of neck pain, dizziness, and headache were predisposed to additional risk of musculoskeletal or concussive injury during 10-weeks of competitive play. [Participants and Methods] Twenty-three female high school soccer athletes provided concussion history and reported pre-season subjective complaints. K-D testing was performed pre and postseason. Read More

Am J Sports Med 2021 Jun;49(7):1892-1903

Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.

Background: Tendons heal by fibrotic repair, increasing the likelihood of reinjury. Animal tendon injury and overuse models have identified transforming growth factor beta (TGF-β) and bone morphogenetic proteins (BMPs) as growth factors actively involved in the development of fibrosis, by mediating extracellular matrix synthesis and cell differentiation.

Purpose: To understand how TGF-β and BMPs contribute to fibrotic processes using tendon-derived cells isolated from healthy and diseased human tendons. Read More

J Sports Sci 2021 Jun 1:1-8. Epub 2021 Jun 1.

University of Primorska, Faculty of Health Sciences, Izola, Slovenia.

Eccentric training proved to be effective in hamstring injury prevention; however, little is known about effects of eccentric hamstring training at long muscle length on hamstring flexibility. Hence, the aim was to evaluate the effect of eccentric training at long muscle lengths on flexibility and passive properties of the hamstring muscles. 34 physically active young adults were randomized to either the control or intervention group (6 weeks of eccentric hamstring training at long muscle length; control group resumed with their usual activities). Read More

J Clin Med 2021 May 9;10(9). Epub 2021 May 9.

Research Group "Empowering Health by Physical Activity, Exercise and Nutrition" [CTS1038], Department of Nursing and Physiotherapy, University of Cadiz, 11009 Cadiz, Spain.

(1) Objective: To analyze the exercise programs used to prevent of acute hamstring injuries in eleven-a-side football players, and their effectiveness. (2) Methods: A systematic review (PRISMA) was conducted (2008-2020), including RCTs, that exclusively used physical exercises as a prevention method. (3) Results: Ten studies were selected considering 14 interventions, including nine different programs: FIFA11+ (11+), Harmoknee, eccentric Nordic Hamstring Exercise (NHE) exclusively, with eccentric exercises, with stretching or with proprioceptive, New Warm-up Program (NWP), Bounding Exercise Program (BEP), the only one with no positive results, and proprioceptive exercises. Read More

JBJS Essent Surg Tech 2020 Oct-Dec;10(4). Epub 2020 Dec 24.

Division of Sports Medicine, Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois.

Background: Endoscopic repair of a proximal hamstring avulsion promotes precise anatomical repair and lowers the risk of neurovascular injury.

Description: Indications for proximal endoscopic repair of the proximal part of the hamstrings include acute tears of 2 tendons with >2 cm of retraction in young active patients, acute complete tears of 3 tendons with >2 cm of retraction, or failed conservative treatment of tears of ≥2 tendons with ≤2 cm of retraction. Repair of a proximal hamstring avulsion is performed using 2 portals. Read More

Front Physiol 2021 13;12:586624. Epub 2021 May 13.

Institute of Health Sciences, Medical College of Rzeszów University, Rzeszów, Poland.

Intern Med J 2021 05;51(5):808-809

Department of Medicine, Calvary Riverina Hospital, Wagga Wagga, New South Wales, Australia.

BMJ Open Sport Exerc Med 2021 10;7(2):e001010. Epub 2021 May 10.

School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK.

Background: The relationship between hamstring muscle injuries (HMIs) that involve the intramuscular tendon and prolonged recovery time and increased reinjury rate remains unclear in elite footballers.

Objective: To determine the association of time to return to full training (TRFT) and reinjury of HMIs using the British Athletic Muscle Injury Classification (BAMIC) and specific anatomical injury location in elite-level football players.

Methods: The electronic medical records of all players at an English Premier League club were reviewed over eight consecutive seasons. Read More

Sports Health 2021 May 26:19417381211014487. Epub 2021 May 26.

IRCCS Istituto Ortopedico Rizzoli, II Clinica Ortopedica e Traumatologica, Bologna, Italy.

Background: In adolescents, the rate of meniscal injury at the time of anterior cruciate ligament (ACL) reconstruction, the rate of ACL graft revision, and clinical outcomes has not yet been investigated.

Hypothesis: In patients younger than 16 years, the rate of meniscal injuries at the time of ACL reconstruction increases with time from injury. The mid-term revision rate and reoperation rate after ACL reconstruction with hamstrings and lateral tenodesis are lower than those reported in literature for isolate ACL reconstruction. Read More

J Sport Rehabil 2021 May 23:1-5. Epub 2021 May 23.

Context: Eccentric knee flexor strength assessments have a key role in both prevention and rehabilitation of hamstring strain injuries.

Objective: To verify the reliability of a clinical test for measuring eccentric knee flexor strength during the Nordic hamstring exercise using a commercially available handheld dynamometer.

Design: Reliability study. Read More

Knee 2021 Jun 21;30:322-336. Epub 2021 May 21.

Alfred Health, Melbourne, Victoria, Australia.

Purpose: To evaluate the efficacy and safety of the Ligament Augmentation and Reconstruction System (LARS) in posterior cruciate ligament (PCL) reconstruction in isolated PCL injuries and multiligament knee injuries, analysing clinical, radiographic, and patient reported outcome measures (PROMs).

Methods: A systematic review according to PRISMA guidelines was performed through Embase via Ovid, PubMed, and the Cochrane Library to identify studies reviewing LARS use for PCL reconstruction. The methodological quality was assessed using the Methodological Index for Non-Randomized Studies (MINORS) criteria. Read More

J Orthop Traumatol 2021 May 21;22(1):20. Epub 2021 May 21.

Clinic for Orthopedics and Trauma Surgery, University Medical Center Schleswig Holstein UKSH Campus Luebeck, Ratzeburger Allee 160, 23538, Luebeck, Germany.

Background: Anterior cruciate ligament (ACL) tear is the most frequent ligamentous injury of the knee joint. Autografts of hamstring (HS) or quadriceps tendons (QT) are used for primary ACL reconstruction. In this study, we planned to examine whether harvesting an HS graft is related to a deficit in dynamic knee stabilisation and strength revealed by dynamic valgus as compared with QT graft or the uninjured leg. Read More

Int J Surg Case Rep 2021 May 15;83:105991. Epub 2021 May 15.

Department of Orthopedics, Faculty of Medicine, Prince of Songkla University, 15 Karnjanavanich Road, Hat Yai, Songkhla 90110, Thailand. Electronic address:

Introduction: There are some possible complications during or after hamstring graft harvesting such as premature graft amputation, medial collateral ligament injury and infrapatellar branch of the saphenous nerve injury. Premature graft amputation can occur by inadequate removal of the accessory branches of the hamstring tendons, poor surgical technique and/or too sharp tendon stripper. In this study, we report a case of premature hamstring graft amputation due to degeneration caused by osteochondroma at the posteromedial aspect of the proximal tibia. Read More

Niger J Surg 2021 Jan-Jun;27(1):42-47. Epub 2021 Mar 9.

Department of Orthopaedics, GMC, Kota, Rajasthan, India.

Introduction: Anterior cruciate ligament (ACL) is a common injury which has been conventionally managed by various graft reconstruction using bone patellar tendon bone, or quadruple hamstring autograft, to name a few. However, all these grafts are associated with many complications. Lately, peroneus longus tendon (PLT) autograft has shown promising results in this field, although there is still a dearth of data on its use. Read More

J ISAKOS 2021 May 12;6(3):170-181. Epub 2020 Nov 12.

Medical Assessment Research Committee, Major League Soccer, New York, New York, USA.

Hamstring injuries (HSI) are the source of significant impairment and disability for both professional and recreational athletes. The incidence and prevalence of HSIs has been well documented in the literature, as they are among the most common soft tissue injuries reported. The significant time loss due to injury and the inherent risk of reinjury pose a significant issue to the athlete, their career longevity and the success of their respective team. Read More

BMC Musculoskelet Disord 2021 May 18;22(1):452. Epub 2021 May 18.

Department of Orthopedic Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, NO. 106, Zhongshan 2nd Road, 510000, Guangzhou, China.

Background: Strength recovery of injured knee is an important parameter for patients who want to return to sport after anterior cruciate ligament reconstruction (ACLR). Comparison of muscle strength between anatomical and non-anatomical ACLR has not been reported.

Purpose: To evaluate the difference between anatomical and non-anatomical single-bundle ACLR in hamstring and quadriceps strength and clinical outcomes. Read More

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2021 May;35(5):556-561

Department of Knee Surgery, Luoyang Orthopedic-Traumatological Hospital of Henan Province (Henan Provincial Orthopedic Hospital), Luoyang Henan, 471002, P.R.China.

Objective: To investigate the short-term effectiveness of arthroscopic single bundle four-strand reconstruction using autologous semitendinosus tendon and anterior half of peroneus longus tendon for posterior cruciate ligament (PCL) injuries.

Methods: A clinical data of 30 patients with PCL injury, who were admitted between December 2015 and September 2018 and met the selection criteria, was retrospectively analyzed. All patients were treated with arthroscopic single bundle four-strand reconstruction using autologous semitendinosus tendon and anterior half of peroneus longus tendon and TightRope technique. Read More

Orthop J Sports Med 2021 May 7;9(5):23259671211005101. Epub 2021 May 7.

Department of Orthopaedic Surgery, School of Medicine, Tulane University, New Orleans, Louisiana, USA.

Background: Patient-reported outcome measures are important to determine outcomes after orthopaedic procedures. There is currently no standard for outcome measures in the evaluation of patient outcomes after proximal hamstring repair.

Purpose: To identify and evaluate outcome measures used after proximal hamstring repair. Read More

Arthrosc Tech 2021 Apr 1;10(4):e981-e986. Epub 2021 Mar 1.

Department of Orthopedics and Traumatology, Hospital of Lithuanian University of Health Sciences (LSMU), Kaunas Clinics, Kaunas, Lithuania.

Anterior cruciate ligament (ACL) reconstruction using a single 4-strand semitendinosus graft is a popular technique; unfortunately, the size (diameter) of the graft varies between 7 and 9 mm in many cases. The literature reveals that smaller diameter of the graft determines poorer Knee injury and Osteoarthritis Outcome Score sport/recreation functional scores and leads to revision surgery. Our Technical Note describes a method of preparing >10-mm size hamstring autografts in all cases while increasing the strength of fixation and covering as much of the anatomical ACL attachment footprint area as possible. Read More